Risk of cardiovascular disease among diabetic patients in rural population of Central India

Abstract

Background: Incidence and prevalence of diabetes is on surge day by day and increased longevity of diabetic patients put them at higher risk of chronic complications of hyperglycemia. Of these complications, atherosclerotic cardiovascular diseases (CVD) are of utmost importance and atherosclerotic cardiovascular diseases are the major cause of premature mortality in patients with type 2 diabetes as well. Regional variation of risk factors and sociocultural diversity of Indian population create a significant difference in atherosclerotic risk among the diabetic population across the country. There is a significant gap in the knowledge of CVD epidemiology and associated risk factors among the Indian population especially among the rural population. The objective of this study was to assess cardiovascular risk among diabetic patients of rural central India.Methods: The present cross-sectional study included 160 diabetic patients (78 males and 82 females) aged 35–75 years from the villages of district Etawah of UP, Central India. Sex-specific Framingham general cardiovascular risk prediction equations were used to calculate the 10years risk for cardiovascular disease. The probable risk factors were determined by cross-tabulation of cardiometabolic parameters with the 10-year cardiovascular risk level.Results: Males were found to be at higher risk of developing CVD in the future as compared to females with a discernible accumulation of adverse cardiovascular risk factors among them. 38.75% patients were at high risk, 37.50% at moderate risk and 23.75% at low risk for developing CVD in the next 10 years. Systolic blood pressure, total cholesterol, triglyceride and smoking contributed significantly to high degree of cardiovascular risk. Presence of cardiovascular risk factors among diabetic patients at diagnosis accentuates the need of intensive management of cardiovascular complications taking into consideration the traditional dietary pattern of the rural population.Conclusions: Both diabetes and CVD have common genetic and environmental antecedents. Furthermore, insulin resistance preceding long before the diagnosis of diabetes enhances atherogenic risk profile and has been delineated as a potential cause for subsequent increased risk of CVD among diabetic patients. There is need of intensive management of cardiovascular risk factors among diabetic individuals. Therefore, there is a need of a comprehensive study design which includes various factors (biological, sociodemographic and genetic) which directly or indirectly influence the disease incidence especially in a country (India) with diverse ethnic population.